Under the microscope: Alopecia

Alopecia: under the microscope | Baldness | Male-pattern baldness | Alopecia areata | Female-pattern baldness

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Each week we look more closely at the most common health conditions.

This week, we're focusing on alopecia.

What is alopecia?

Alopecia is baldness or loss of hair. It affects both men and women and there are a couple of different types. Male-pattern baldness (androgenic alopecia) is the most common, but women suffer from something similar called androgenetic alopecia (female-pattern baldness), mainly after the menopause.
The other type is alopecia areata that affects 1 in 100 people. It leaves patches of baldness around the size of a coin. They are usually associated with the scalp but can occur anywhere on the body.

How do you get alopecia?

Ageing is the most obvious cause. On average, we naturally lose 40-120 hairs a day.
Male and female-pattern baldness is caused by sensitive hair follicles.
Alopecia areata is a problem with the immune system and often runs in the family.

There are also some conditions that can make you lose your hair, such as anaemia, overactive or underactive thyroid and drug treatment for cancer.

Hair loss is not caused by a lack of vitamins.

How do I know if I have alopecia?

Male-pattern baldness is easy to spot, beginning with a receding hairline.
Female-pattern baldness usually starts after the menopause and hair on top of your head will thin first.
There are no obvious symptoms of alopecia areata, other than the bald patches, so you may not notice them at first.

What are the treatments for alopecia?

There are two medicines that have been shown to treat male-pattern baldness: finasteride and minoxidil. Minoxidil is also used to treat female-pattern baldness.
You can only get finasteride on private prescription and comes in the form of a tablet that has to be taken daily.
Minoxidil is available as a lotion that you rub on your scalp. Its success is not guaranteed and usually takes at least 4 months to show any effect.

There is no proper treatment for alopecia areata, mainly because no-one is exactly sure why it occurs. However, in most cases the hair grows back after around a year, without the need for any treatment.

Are there any complications to alopecia?

The main side-effects and complications of alopecia are the psychological effects of going bald. Some people get depressed or anxious and may take time to come to terms with losing their hair. You may need to see your doctor if this is how the condition is affecting you.